Melgar Virgilio, Espinosa Etual, Cuenca Dalia, Valle Vanessa, Mercado Moisés
Servicio de Endocrinología, Unidad de Investigación Médica en Endocrinología Experimental, Hospital de Especialidades, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, Distrito Federal, México.
Rev Med Inst Mex Seguro Soc. 2015 Jan-Feb;53(1):74-83.
Acromegaly is a rare condition characterized by the excessive secretion of growth hormone (GH), usually by a pituitary adenoma. The clinical manifestations of acromegaly include enlarged hands, feet and face, headaches, arthralgias, fatigue and hyperhydrosis. This condition is also associated with comorbidities such as hypertension and diabetes in a significant proportion of patients and frequently compromises life quality and life expectancy. The biochemical diagnosis of acromegaly rests on the demonstration of an autonomous secretion of GH by means of the measurement of glucose-suppressed GH levels and the serum concentration of insulin like growth factor type 1 (IGF-1). The localizing method of choice is magnetic resonance image of the selar area, which in 70 % of the cases reveals the presence of a macroadenoma. Even though the primary treatment is usually the transsphenoidal resection of the adenoma, the majority of patients require a multimodal intervention that includes radiotherapy, as well as pharmacological therapy with somatostatin analogs and dopamine agonists. The latter approach has resulted in a significant reduction in mortality and in an improvement in the quality of life.
肢端肥大症是一种罕见病症，其特征是生长激素（GH）分泌过多，通常由垂体腺瘤引起。肢端肥大症的临床表现包括手足和面部增大、头痛、关节痛、疲劳和多汗。在相当一部分患者中，这种病症还与高血压和糖尿病等合并症相关，并且常常影响生活质量和预期寿命。肢端肥大症的生化诊断依赖于通过测量葡萄糖抑制后的GH水平和血清1型胰岛素样生长因子（IGF-1）浓度来证明GH的自主分泌。首选的定位方法是蝶鞍区磁共振成像，70%的病例中可显示存在大腺瘤。尽管主要治疗通常是经蝶窦切除腺瘤，但大多数患者需要多模式干预，包括放疗以及使用生长抑素类似物和多巴胺激动剂进行药物治疗。后一种方法已使死亡率显著降低，并改善了生活质量。
